Paratrygon aiereba irradiated anti-mucus serum reduce edematogenic activity induced in experimental model.

Accidents by freshwater stingrays are common in northern Brazil, there is no specific therapy for high morbidity and local tissue destruction. The irradiation of venoms and toxins by ionizing radiation has been used to produce appropriate immunogens for the production of antisera. We planned to study the efficacy of stinging mucus irradiation in the production of antisera, with serum neutralization assays of edematogenic activity and quantification of cytokines performed in animal models of immunization with native and irradiated mucus of Paratrygon aiereba, a large freshwater stingray. Antiserum potency and its cross-reactivity with mucus from other freshwater stingrays were detected by ELISA. Immunization models demonstrated the ability to stimulate a strong humoral response with elevated levels of serum IgG detectable by ELISA, and both native and irradiated mucus were immunogenic and capable of recognizing mucus proteins from other freshwater neotropical stingrays. Mucus P. aiereba causes cellular and humoral adaptive immune responses in cells of immunized mice producing antibodies and cytokines such as TNF-α, IL-6 and IL-17. Rabbit antisera immunized with mucus from P. aiereba irradiated at 2 kGy showed a significant reduction of mucus-induced edematogenic activity in mice. Our data suggest that the use of antisera against freshwater stingray mucus show the possibility of specific therapy for these accidents.

Peripherally inserted central catheters are associated with lower risk of bloodstream infection compared with central venous catheters in paediatric intensive care patients: a propensity-adjusted analysis.

PURPOSE: Central line-associated bloodstream infection (CLABSI) is an important cause of complications in paediatric intensive care units (PICUs). Peripherally inserted central catheters (PICCs) could be an alternative to central venous catheters (CVCs) and the effect of PICCs compared with CVCs on CLABSI prevention is unknown in PICUs. Therefore, we aimed to evaluate whether PICCs were associated with a protective effect for CLABSI when compared to CVCs in critically ill children. METHODS: We have carried out a retrospective multicentre study in four PICUs in São Paulo, Brazil. We included patients aged 0-14 years, who needed a CVC or PICC during a PICU stay from January 2013 to December 2015. Our primary endpoint was CLABSI up to 30 days after catheter placement. We defined CLABSI based on the Center for Disease Control and Prevention's National Healthcare Safety Networks (NHSN) 2015 surveillance definitions. To account for potential confounders, we used propensity scores with inverse probability weighting. RESULTS: A total of 1660 devices (922 PICCs and 738 CVCs) in 1255 children were included. The overall CLABSI incidence was 2.28 (95% CI 1.70-3.07)/1000 catheter-days. After covariate adjustment using propensity scores, CVCs were associated with higher risk of CLABSI (adjHR 2.20, 95% CI 1.05-4.61; p = 0.037) compared with PICCs. In a sensitivity analysis, CVCs remained associated with higher risk of CLABSI (adjHR 2.18, 95% CI 1.02-4.64; p = 0.044) after adding place of insertion and use of parenteral nutrition to the model as a time-dependent variable. CONCLUSIONS: PICC should be an alternative to CVC in the paediatric intensive care setting for CLABSI prevention.

Nitrosylation: an adverse factor in Uremic Hemolytic Syndrome. Antitoxin effect of Ziziphus mistol Griseb.

Toxins of Escherichia coli (STEC) causing Uremic Hemolytic Syndrome (UHS) generate oxidative stress in human blood with more production of nitric oxide (NO) than reactive oxygen species (ROS). Shiga toxin (Stx) together with the hemolysin (Hly) increased lipid oxidation, as evaluated by malondialdehyde MDA and oxidation of proteins. The addition of Ziziphus mistol Griseb extracts decreased NO, ROS, MDA and simultaneously caused an increase in the degradation of oxidized proteins to advanced oxidation protein products (AOPPs) in controls and samples with toxins. Furthermore, the nitrosylated proteins/AOPP ratio was reduced, due to the increase of AOPP. Z. mistol Griseb extracts exhibited a high proportion of polyphenols and flavonoids, with evident correlation with ferrous reduction antioxidant potential (FRAP). The plasma of eight children with UHS showed oxidative stress and NO stimulus, comparable to the effect of toxins during the assays in vitro. UHS children presented high levels of nitrosylated proteins respect to control children of similar age. Although the degradation of oxidized proteins to AOPP rose in UHS children, the nitrosylated proteins/AOPP rate increased as a consequence of the elevated nitrosative stress observed in these patients.

[The importance of genetic counseling at sickle cell anemia]. / A importância do aconselhamento genético na anemia falciforme.

The genetic counseling has the purpose of guiding people through a conscientious and balanced decision making process regarding procreation, helping them to understand how the hereditary succession can contribute for the occurrence or risk of recurrence of genetic illnesses, as it is the case of the sickle cell anemia. This type of anemia is the most prevalence hereditary illness in Brazil and has clinical complications that can harm the development, the quality of life and lead to death. The present article has the objective to clarify the importance of the genetic counseling for the anemia carriers or falciform trace, aiming at to point out the main characteristics of this illness, its complications and how the diagnosis is made. The study was based on the bibliographical method, looking for studies that deal with this type of anemia and genetic counseling, relating them with guidelines and data from the Health Ministry. Based on the found data, we infer the importance of genetic counseling for the individuals who present the heterozygote form of sickle cell anemia - the falcemic trace - and highlight the need to implement precocious diagnostics programs and genetic and social/psychological orientation for those with the disease or falciform trace.

A importância do aconselhamento genético na anemia falciforme / The importance of genetic counseling at sickle cell anemia

O aconselhamento genético tem a finalidade de nortear as pessoas sobre a tomada de decisões a respeito da procriação, ajudando-as a entender como a hereditariedade pode colaborar para a ocorrência ou risco de recorrência de doenças genéticas, como é o caso da anemia falciforme. Esta anemia é a doença hereditária de maior prevalência no Brasil, com complicações clínicas que podem prejudicar o desenvolvimento, a qualidade de vida e levar à morte. O presente artigo tem o intuito de elucidar a importância do aconselhamento genético para os portadores de anemia ou traço falciforme, visando salientar as principais características dessa doença, suas complicações e como é feito o diagnóstico e a captação desses doentes. O estudo realizado foi embasado no método bibliográfico, buscando estudos que dissertam sobre esse tipo de anemia e aconselhamento genético, correlacionando-os com as diretrizes e dados do Ministério da Saúde. A partir dos dados encontrados, infere-se a importância do aconselhamento genético para os indivíduos que apresentam a forma heterozigota da anemia falciforme - o traço falcêmico - e destaca-se a necessidade de implantação de programas de diagnóstico precoce e de orientação tanto genética quanto social e psicológica para as pessoas que possuem a doença ou o traço falciforme.

The genetic counseling has the purpose of guiding people through a conscientious and balanced decision making process regarding procreation, helping them to understand how the hereditary succession can contribute for the occurrence or risk of recurrence of genetic illnesses, as it is the case of the sickle cell anemia. This type of anemia is the most prevalence hereditary illness in Brazil and has clinical complications that can harm the development, the quality of life and lead to death. The present article has the objective to clarify the importance of the genetic counseling for the anemia carriers or falciform trace, aiming at to point out the main characteristics of this illness, its complications and how the diagnosis is made. The study was based on the bibliographical method, looking for studies that deal with this type of anemia and genetic counseling, relating them with guidelines and data from the Health Ministry. Based on the found data, we infer the importance of genetic counseling for the individuals who present the heterozygote form of sickle cell anemia - the falcemic trace - and highlight the need to implement precocious diagnostics programs and genetic and social/psychological orientation for those with the disease or falciform trace.

Normatização da abertura de ligas acadêmicas: a experiência da Faculdade de Medicina de Botucatu / Regulation of student leagues: the experience at the Botucatu School of Medicine

A criação de ligas acadêmicas por estudantes de Medicina tem ocorrido em todo o Brasil. Aceitas como atividades extracurriculares de extensão universitária, as ligas trazem tanto benefícios como riscos à formação médica. Assim, a abertura de ligas deveria ser racionalizada, visando ao aperfeiçoamento de suas atividades. Neste relato, descrevemos a normatização adotada na Faculdade de Medicina de Botucatu - Universidade Estadual Paulista (FMB/Unesp), contextualizando- a numa discussão sobre a importância das ligas como atividades extracurriculares e os prejuízos que podem trazer à formação médica. A normatização contém orientações processuais e um conjunto de critérios para avaliação dos projetos de abertura de novas ligas. Os critérios avaliam a relevância da proposta, os objetivos, o modelo de gestão planejado e a ideologia da formação. A utilização destas diretrizes tem capacitado o desenvolvimento de projetos de novas ligas e desencadeado na escola o aprofundamento de reflexões sobre a função de ligas acadêmicas.

Student leagues have been created by medical students all across Brazil. Accepted as extracur ricular university extension activities, the leagues have produced both benefits and risks for medical training. Student leagues thus need to be rationalized, with the aim of improving their activities. This report describes the regulation adopted by the Botucatu School of Medicine (Universidade Estadual Paulista, FMB/UNESP), framed within a discussion of the importance of such leagues as extracurricular activities and the potential harm they can cause to medical training. The regulation contains procedural guidelines and a set of criteria for the evaluation of proposals to create new leagues. The criteria assess the proposal's relevance, objectives, planned management model, and training ideology. The use of these guidelines has allowed the development of projects for new leagues and triggered more in-depth reflection in the school on the role of student leagues.